Sleep is crucial for our overall health, yet uninterrupted rest can be difficult for many to achieve. As we age, our sleep patterns naturally change, and waking up during the night can become more frequent. Understanding the reasons behind these nighttime awakenings at various stages of life can help us better manage our sleep. By adopting healthy sleep practices and addressing any underlying health issues, we can enhance sleep quality and overall well-being. Several factors contribute to waking up at night, such as the need to urinate, sleep apnea, overheating, and dietary choices, among others (Jenna Fletcher, 2023).
Waking up during the night is a normal and healthy part of sleep, whether you’re a baby, child, or adult. But what causes these awakenings, and how can we reduce their impact on our rest?
Nighttime awakenings are similar to the unconscious movements we make during sleep. Excessive movement can disrupt rest, but insufficient movement can lead to issues such as muscle or tendon strain from remaining in one position too long, making us more sensitive to internal threats like breathing difficulties (Halasz et al., 2004; Eckert and Younes, 2014).
Therefore, night wakings should not be viewed as an obstacle to quality sleep. Rather than aiming to eliminate them, the focus should be on minimizing their disruption and addressing the underlying issues that prevent us from returning to sleep. In a study conducted in the United States, researchers used electroencephalograms to assess the sleep patterns of 76 healthy adults aged 18 to 70. Across all age groups, participants experienced an average of 80 to 130 arousals per night. On average, adults experience more than 20 sleep disruptions each night, with the number rising to over 40 after the age of 50 (Bonnet and Arand, 2007).
Why do babies wake us up so frequently ?
Initially, newborns lack well-established circadian rhythms, meaning their sleep patterns are often misaligned with the natural day-night cycle. Additionally, young infants need to feed during the night because their small stomachs cannot hold enough milk to last through the night.
Furthermore, babies experience distinct sleep stages and cycles. In the first three months after birth, they spend most of their sleep time in a phase known as active sleep, which is similar to REM sleep and is particularly restless. During this stage, babies may twitch, move around, or make sounds, leading us to mistakenly believe they are awake. When we intervene, we may inadvertently wake them, causing a night awakening. A newborn’s sleep cycle typically lasts only 50-60 minutes (Grigg-Damberger, 2017).
As a result, infants are more prone to waking up during the night. For instance, a research investigation into the sleep habits of healthy infants aged 2 and 9 months discovered that they averaged three major awakenings each night (Anders, 1978). Another study revealed that approximately 50% of 4-month-old infants woke their parents at least once between midnight and 5:00 AM (Henderson et al., 2010).
Night wakings without strife: Babies can awaken without making you miserable.
A study conducted in an urban, westernized population suggests that night wakings in infants are more common than parents often realize. The researchers found that babies frequently woke up spontaneously, remained relatively quiet, and easily fell back to sleep without their parents being aware ( (Tikottzky and Volkovich, 2019). Therefore, night wakings do not necessarily lead to sleep problems. Many people can feel well-rested despite waking up during the night, and parents are not always disturbed by their children’s wakings. Night wakings are perceived as problematic only when a child cannot self-soothe and when parents experience significant sleep disruptions. It is normal for young babies to wake during the night, and there is no proven method to prevent it. Research on sleep training has shown that such programs do not significantly reduce the frequency of night wakings in children (Park et al., 2022)
How can we better manage night wakings in young babies?
Be patient with your baby’s circadian rhythms; these developmental issues will improve as the baby matures. Sleep in the same room as your baby, keeping all necessary baby care items within easy reach.
Avoid stimulating your brain with energetic movements or electronic media. Protect your own circadian rhythms by minimizing light exposure. If you need lighting, use dim lighting and opt for an amber-colored bulb, which is less likely to disrupt sleepiness or hinder your ability to fall back asleep.
Night wakings in children :
Night wakings are common in young children, affecting about 20% to 30% of infants, toddlers, and preschoolers. The impact of disturbed or insufficient sleep in young children can be significant and far-reaching (Beebe et al., 2002). Typically, night wakings are classified under the diagnostic category of behavioral insomnia of childhood, specifically the sleep onset association type. In these cases, children rely on sleep associations (such as rocking, feeding, or the presence of a parent) to fall asleep at bedtime. During normal nighttime arousals, these children struggle to recreate their sleep associations and require parental assistance to return to sleep. Caregivers generally view night wakings as problematic only when they involve signaling behaviors (such as crying, protesting, or getting out of bed) and are frequent or prolonged (Mindell et al., 2006). According to the American Academy of Sleep Medicine, a study has shown that two behavioral interventions for addressing bedtime issues and night wakings in young children—unmodified extinction (including extinction with parental presence) and preventive parent education—have received strong empirical support from high-quality studies. Although it is natural for children to experience brief awakenings during sleep cycles, frequent disruptions can affect their mood, energy, and overall well-being. Understanding the causes of night wakings and implementing effective management strategies can help ensure restorative sleep for the entire family.
Common causes of night wakings in school age children
- Sleep Apnea: Though less common, sleep apnea can lead to frequent awakenings due to breathing difficulties, often accompanied by snoring or gasping.
- Anxiety and Stress: Pressures related to school, friendships, and extracurricular activities can create nighttime worries. Anxiety often arises during quiet moments, making it difficult for children to fall asleep or stay asleep.
- Inconsistent Sleep Routines: Irregular bedtimes or excessive screen time before bed can disrupt a child’s natural sleep-wake cycle, contributing to nighttime awakenings.
- Environmental Factors: Noise, light, or an uncomfortable sleep environment (e.g., a room that is too hot or cold) can interfere with uninterrupted sleep.
Strategies to address night wakings:
- Establish a Consistent Sleep Routine: Create a predictable bedtime routine to signal to the child that it is time to wind down and prepare for sleep.
- Ensure a Sleep-Friendly Environment: Make the sleep environment quiet, dark, and comfortable to encourage restful, uninterrupted sleep.
- Limit Screen Time: Reduce exposure to screens at least an hour before bedtime to prevent overstimulation and help the child relax.
- Address Stress and Anxiety: Identify and manage any sources of stress or anxiety that may disrupt the child’s ability to fall asleep or stay asleep.
- Promote Physical Activity: Encourage regular physical activity during the day to help the child feel naturally tired and ready for sleep at night.
Night wakings in children aged 6 to 12 years are typically manageable with consistent routines and attention to their physical and emotional well-being. By identifying the underlying causes and applying effective strategies, parents can help their children achieve restful, uninterrupted sleep, which is essential for their overall growth and development. With time and support, most children outgrow frequent night wakings.
REFERENCES:
- Bonnet MH and Arand DL. 2007. EEG Arousal Norms by Age. J Clin Sleep Med. 3(3): 271–274.
- Mindell JA and Williamson AA. 2018. Benefits of a bedtime routine in young children: Sleep, development, and beyond. Sleep Med Rev. 40:93-108.
- Park J, Kim SY, and Lee K. 2022. Effectiveness of behavioral sleep interventions on children’s and mothers’ sleep quality and maternal depression: a systematic review and meta-analysis. Sci Rep. 12(1):4172.
- Beebe, DW, and Gozal, D. Obstructive sleep apnea and the prefron tal cortex: towards a comprehensive model linking nocturnal upper airway obstruction to daytime cognitive and behavioral deficits. J Sleep Res 2002;11:1-16 13. Keren, M, Feldman, R, and Tyano, S.